9703-096 (PATIO) 1 �
LICENSED CONTRACTOR DECLARATION BUILDING PERMIT PERMIT# CONTROL#
U) I hereby affirm under penalty of perjury that I am licensed under provisions of o C pp
r Chapter 9 (commencing with Section 7000) of Division 3 of the Business and DATE 45 O
O
04 W Professionals Code,and my License is in full force and effect. 3/26197 VALUATION S 3,3#33 41) LOT TRACT
O. :D co License# Lic.Class Exp.Date
u1 j 1102`-� BI CR 61-101,48ADDRESS 4411-209AVENUE 5{) APN
Z r- Date` ^" { Signature of Contractor : 0-' OWNER CONTRACTOR/DESIGNER/ENGINEER
� O � 9 to r
CO °� OWNER-BUILDER DECLARATION KrIT11f R-VEStr KTif'i`H 1,,tR11SF G(11Nr.Pax 1.,CC7Pi":''.
W W I hereby affirm under penalty of perjury that I am exempt from the Contractor's 8009 AVE 50 '8020`)"ME 50
~ U) License Law for the following reason: LA QIAN1 A CA 92253 LA,QUINTA C"A, 02253
Z_ ( ) 1, as owner of the property, or my employees with wages as their sole C{.l.cy) 73 322#1 (;11133,13
compensation,will do the work,and the structure is not intended or offered for
sale(Sec.7044, Business&Professionals Code). USE OF PERMIT
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals PAIJO
Code).
C'') O I am exempt under Section , B&P.C.for this reason Abii.A ifs KV.CoV}at.ti0 PA I iQ
LO
N Date Signature of Owner
ON
CA
Q WORKER'S COMPENSATION DECLARATION
C:) 2 Z I hereby affirm under penalty of perjury one of the following declarations:
FZ p O 1 have and will maintain a certificate of consent to self-insure for workers' Ni.%ii�yluT�.t1'C)�:� 98.00 Sty'
X W L= compensation, as provided for by Section 3700 of the Labor Code, for the
O � Q performance of the work for which this permit is issued.
M Q U ()() I have and will maintain workers'compensation insurance,as required by
O U Q Section 3700 of the Labor Code, for the performance of the work for which this
rn H permit is issued. My workers' compensation insurance carrier & policy no. are:
It Z Cartier Policy No.
cb o E i2f.�k1f)1` V l«'V't'3MAJ,C'1)CONT or ION 1.30 3.40
J (This section need not be completed if the permit valuation is for$100.00 or less). ►•V101i'i".1+`i V.SWAI.MAR%
( ) I certify that in the performance of the work for which this permit is issued, PLAN
I shall not employ any person in any manner so as to become subject to the 4-f-1Nyfgi1tr'rt0NPOP 43 nn
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor r t'r 1id+'Mt..q1t iN,t.13H .W."1;t 1910007241 -000
3 fode, I shall forthwith comply with those provisions.
ate:4-I Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to$100,000,in
addition to the cost of compensation,damages as provided for in Section 3706
of the Labor Code,interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his +
application. '
1.Each person upon whose behalf this application is made&each person at' c
whose request and for whose benefit work is performed under or pursuant to
' any permit issued as a result of this applicaton agrees to, &shall, indemnify ; [7(,-'tT:Yjp,t,!"i7N`�'y"N.Q?(_"�T itd ANt;}P1,,^
& hold harmless the City of La Quinta, its officers, agents and employees. ���® LESS � RIc'-1 AID FTAES }C}00
2.Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
1 144, permit, or cessation of'work for 180 day's will subject permit to cancellation. i'd)t'AL PFAI%1114'lt`FIO�i OUE NOW*
v v I certify that I have read this application and state that the above information is MAR 2 g 1997 IIIIIIIIII
60
• correct. I agree to comply with all City, and State laws relating to the building IIIIIIIIIIIIIII
construction, and hereby authorize representatives of this City to enter upon �, � IE
the above-mentioned property for inspection purposes. etCITY _
RECEIPT BYFINALED INSPECTO
/Signature (Owner/Agent) Date
� -
i
1 -
INSPECTION RECORD
OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR
BUILDING APPROVALS MECHANICAL APPROVALS
Set Backs Underground Ducts
Forms&Footings Ducts
Slab Grade Return Air
Steel Combustion Air
Roof Deck Exhaust Fans
O.K to Wrap F.A.U.
Framing Compressor
Insulation Vents
Fireplace P.L. Grills
Fireplace T.O. Fans 6 Controls
Party Wall Insulation Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall-Int.Lath
Final
Final POOLS - SPAS
BLOCKWALL APPROVALS steel
Set Backs Electric Bond
Footings Main Drain
Bond Beam Approval to Cover
Equipment Location
Underground Electric
Underground Plbg.Test
Final I I Gas Piping
PLUMBING APPROVALS Gas Test
Electric Final
Waste Lines Heater Final
Water Piping Plumbing Final
Plumbing Top Out Equipment Enclosure
Shower Pans O.K.for Finish Plaster
Sewer Lateral Pool Cover
Sewer Connection Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice(Gas)
ELECTRICAL APPROVALS
Temp.Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp.Use of Power
Final
UU14 Notice(Perm)
CITY OF LA.QUINTA �.
00f BUILDING & SAFETY DEPARTME,�
777-7012
INSPECTION REQUEST
777-7153 Off(
i
Owner KEITH REESE
Contractor KEITH �1
Permit Number 9703-096
POST ON JOB IN CONSPICUOUS P CE
i
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 80-209 AVENUE 50
98 S.F. COVERED PATIO
TYPE OF INSPECTION DATE INSP.
VOUNUATION&ULTUACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS&GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
-ROUGH PLUMBING
ROUGH GAS&GAS TEST
HEATING&VENT-A/C
FIRM ACE
ROOF 7z1
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE-ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE&GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING-A/C
HOUSE NUMBERS
JOB COMPLETED t L
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
7/96 TURN 6N UTILITIES OR OCCUPY BUILDING